medicaid

Digging into CCO Reimbursements

The Lund Report spoke with experts at the Oregon Health Authority to dig into recent rate increases announced for the state’s Medicaid-funded coordinated care organizations. Here’s what they had to say.

Oregon’s coordinated care organizations are getting a raise from the state – about $8 more per Medicaid member per month than they expected to receive in 2018.

Nurses Association Supports Drive to Amend Constitution

Red-shirted citizen activists of Health Care for All Oregon packed the hearing room in a special evening meeting of the House Health Committee to lend support to Rep. Mitch Greenlick’s ballot push to declare healthcare a fundamental right for Oregonians.

As she testified Wednesday night, Carolanne Fry said it should’ve been her mother’s 53rd birthday. Instead, it was the third anniversary of her funeral, her life cut short of cancer, a condition she only learned of a few months before her death.

COFA Islanders Rush to Enroll, but Face Obstacles in Special Insurance Program

A tight deadline has insurance brokers working overtime to help a group of Pacific Islanders to get insurance, but a rule requiring them to pay deductibles upfront has some members facing collection agencies.

The state is aggressively signing up people for a special health insurance program for Pacific Islanders, but the design of the program has barriers that are making it hard for the recipients to use their care, and some have been sent to collections.

Lori Coyner Out as Oregon Medicaid Director

Coyner left voluntarily, the Oregon Health Authority says. Her departure after a year and a half in the job follows heavy criticism of the state’s Medicaid re-enrollment process.

A year and a half after being named Oregon’s state Medicaid director, Lori Coyner has left state government—leaving David Simnitt, who has been the Oregon Health Authority’s health policy director, to fill the role on an interim basis until a new Medicaid director is hired.

OHA Routinely Keeping Medicaid Members out of CCOs

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As they jump through a difficult re-enrollment process, 147,000 Medicaid members have been caught outside coordinated care organizations with little access to care, which could cause the state and CCOs to lose $200 million per year in Medicaid funding, mostly from federal sources.

The Oregon Health Authority’s Medicaid renewal plan is marooning recipients for weeks or months in a separate system outside the state’s coordinated care organizations, limiting members access to care and keeping funds away from the local CCOs

Oregon Health Authority Disputes Auditor’s Allegations It Misused Medicaid Funds

An audit by the Oregon Secretary of State’s office found that health officials may not have adequately checked to see if people met Medicaid requirements before enrolling them in health plans. But the health authority says the audit missed key context, including a federal waiver governing Medicaid renewals.

Two powerful Oregon agencies are butting heads over whether the state is using federal Medicaid dollars correctly.

Medicaid Expansion Too Big, Too Successful and Too Politically Disruptive to Gut

Oregon’s innovative Medicaid expansion under the CCOs faces big tests with Congress and President-elect Donald Trump promising to repeal the Affordable Care Act while Oregon faces a $1.7 billion budget deficit.

For 10 years, Mel Rader, executive director of Upstream Public Health, didn’t have access to health insurance – and he was sick for more than three of those years. His experience convinces him it’s a “moral imperative to provide health insurance for those who cannot afford it.”

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